两种不同结缔组织移植技术在上前牙区即刻种植修复中的应用

目的:比较带蒂结缔组织瓣移植( pedicle subepithelial connective tissue graft,PSCTG与游离结缔组织瓣移植( free subepithelial connective tissue graft,FSCTG)增厚种植体周围角化龈的量以达到稳定而良好的种植修复增量效果和美学效果。方法:29例满足即刻种植适应症的上前牙,拔出后即刻种植,同期采用PSCTG或FSCTG增加种植体周围软组织量,运用临时冠修复塑形,观察术后临床效果。结果:带蒂结缔组织瓣移植组(下文简称带蒂组)移植瓣成活率100%,游离结缔组织瓣移植(下文简称游离组)为93.33%。带蒂组移植后半年唇侧龈组织厚度(Facial gingival tissue thickness, FGTT)增加(1.572±0.74) mm,游离组增加(1.45±0.61) mm。移植1年时,带蒂组红色美学( the pink esthetic,PES)得分为(8.50±1.34)分,游离组(7.80±1.74)分,两组红色美学各指标评分差异无统计学意义。带蒂组PES达到6分及以上的比率高于游离组。结论:即刻种植(immediate implant placement and provisionalization,IIPP)联合PSCTG与联合FSCTG一样,短期唇侧龈厚度增量和红色美学效果均较好,而PSCTG由于自身血供更易成活固定。

Soft Tissue Augmentation for Immediate Implant Placement and Provisionalization in the Maxillary Anterior Area Using Two Different Methods: a Randomized Controlled Clinical Trial.

Objective: The aim is to compare pedicle connective tissue grafts (PSCTG) with free subepithelial connective tissue grafts (FSCTG) in augmenting soft tissue to have good esthetic outcome in the anterior maxilla. Methods: Twenty-nine immediate implantations in the esthetic zone were randomly allocated to the PSCTG group or the FSCTG group. The clinical outcomes were observed. The Mann-Whitney U test was used to compare the PES score between 2 groups. Results: The clinical survival rates were 100% and 93.33% for the group grafted with PSCTG and group grafted with FSCTG, respectively. The change of facial gingival tissue thickness was (1.57±0.74)mm and (1.45±0.61)mm. The PES score was 8.50±1.34 and 7.80±1.74, respectively. There was not significant difference between two groups. The aesthetically acceptable frequency for the PSCTG group was higher than that for the FSCTG group. Conclusion: Soft tissue augmentation for immediately single tooth implantation in the anterior maxilla was successfully performed using both techniques. The PSCTG was more likely to survive because of better blood supply.